Data was collected by documentation and record of the patients coming to the ENT department.The surgical procedure was done in cases where foreign bodies were impacted and on uncooperative patients. The number of children was 95 and is comprised of 59 males (62%) and 36 females (38%). 48 (40%) children were below the age of 5 years, 54 (45%) were 6-10 years of age and 18 (15%) in the age group of 11–14 years.

The commonest objects were beads and insects. The commonest presentation was local pain, found in 49% of cases. Other means of presentation include verbal admission by the child (31.3%), an incident witnessed by the caregiver (7%), bleeding from the ear (4%), ear discharge (1.1%), fever (2.8%), tinnitus (1.4%), and others (3.4%).

Demographic data recorded included the patient's age and gender, type of foreign body encountered, and how and in what setting the object was successfully extracted from the EAC. The duration of the foreign body presence in the external auditory canal was also recorded when available.

The number of children was 95 and is comprised of 59 males (62%) and 36 females (38%). 48 (40%) children were below the age of 5 years, 54 (45%) were 6-10 years of age and 18 (15%) in the age group of 11–14 years. The commonest objects were beads and insects. The commonest presentation was local pain, found in 49% of cases. Other means of presentation include verbal admission by the child (31.3%), an incident witnessed by the caregiver (7%), bleeding from the ear (4%), ear discharge (1.1%), fever (2.8%), tinnitus (1.4%), and others (3.4%).

64 of children presented within 24 hours of having the foreign body enter the external auditory canal. In 28 patients, the foreign body clearly had been present in the external auditory canal greater than 24 hours. In 10 patients, an accurate assessment of the length of time the object was in the external auditory canal could not be determined, and in 18 patients no duration information was available. The objects were removed by different methods including irrigation, suctioning, or instrumentation with or without the aid of an operating microscope. 34 patients (28.3%) required surgical removal under general anaesthesia. Of these 34 patients, 20 (70.6%) were below the age of 5 years.

Irritation caused by pre-existing otologic diseases such as cerumen impaction, otitis externa and otitis media were the most significant predisposing etiologic factors in one study; mental retardation, curiosity, accidental placement, and fun-making were of comparatively less importance [1].

Commonest objects in our report were beads, insects and seeds. While beads may be graspable, the current study had less success with smooth and spherical foreign bodies. In some studies, smooth and spherical foreign bodies had the worst outcomes [10,11].

Dimuzio et al found that the complication rates for smooth-surfaced objects were considered higher than those of irregularly-shaped objects: 70% versus 14% (p<0.001), which is understandable as the objects cannot be readily grasped [10]. Schulze et al found that spherical foreign bodies were associated with the least success rates for the removal and the highest complication rate, and the complication rate showed the greatest dependence on the presence or absence of multiple attempts [11].

The removal of an EAC foreign body can be a simple process if the object is in the lateral one-third of the EAC and adequate instrumentation and staff support are available. Because the EAC narrows acutely at the junction of its cartilaginous and osseous portions, objects within the medial two-thirds of the EAC present a greater challenge.

Manipulation of objects in the osseous portion of the ear canal is both potentially painful and traumatic as the skin overlying the periosteum is exquisitely tender and highly vascular. A variety of instrumentation should be available for extraction of aural foreign bodies given the variety of objects encountered. Frazier tip suctions, alligator forceps, Hartman forceps, cerumen loops, and right-angle ball hooks constitute the typical armamentarium.

If an aural foreign body is not easily removed or if adequate instrumentation or staffing is not available, a referral to an otolaryngologist is indicated. Multiple attempts at removal serve to decrease cooperation on the part of the child, making the need for anaesthesia more likely. Multiple unsuccessful attempts at foreign body removal also increase the risk of traumatic canal abrasions, lacerations, and bleeding, all which further complicate future extraction attempts by the otolaryngologist.

• The type and location of the foreign body in the external auditory canal
• For successful removal of the foreign body requires:

1. Cooperation of the patient
2. The assistance of family members
3. Patient positioning and
4. Well thought out plan to manageRemoval of foreign body with least or no complication

Dr. Khetawat Ravinder Raja and Dr. Feroz Basha Shaik started the study, and both participated in data acquisition and analysis, management of cases and gave critical intellectual contributions to the manuscript. Both authors read and agreed to the final version of the manuscript.

Disclosure: As the current study found that foreign body ear was most common, coming to our ENT department hence the present study took up this topic for studying the common age group,common foreign bodies, type of foreign bodies and also the positioning of foreign body in the external auditory canal. To educate the masses that removal of foreign bodies should be removed by an otolaryngologist and not unqualified persons. Proper instrumentation under proper vision with the headlight,microscope and endoscopy help in smooth removal along with good assistance from staff, will give less or no complications.Post-procedure counselling given to the children and their parents, on how to take care of ear and not to repeat this again to protect the ear as well as their hearing.